A nurse is caring for a client who has lung cancer and is scheduled for a lobectomy. The nurse should prepare the client to expect which of the following after the procedure?

Choice A reason: The use of erythropoiesis-stimulating agents (ESAs) is indicated for anemia due to chemotherapy¹. However, the client's hemoglobin (Hgb) level is 12.1 g/dL, which is within the normal range (normal: 12-15.5 g/dL for women). Therefore, administering an ESA is not indicated based on the Hgb level provided.

Choice B reason: A diet with increased protein can be beneficial for patients undergoing chemotherapy as it helps in tissue repair and immune system function. However, the client's albumin level is 4.5 g/dL, which falls within the normal range (normal: 3.4-5.4 g/dL), suggesting adequate protein intake. Thus, there is no indication that the client requires an increased protein diet based on the albumin level provided.

Choice C reason: The client's white blood cell (WBC) count is 1,400/mm³, which is below the normal range (normal: 4,500-11,000/mm³). This condition, known as leukopenia, significantly increases the risk of infection³. Therefore, the nurse should prioritize monitoring for signs of infection and implementing infection control measures.

Choice D reason: The client's platelet count is 170,000/mm³, which is within the normal range (normal: 150,000-450,000/mm³). Although cisplatin can cause thrombocytopenia, the current platelet count does not indicate an increased risk for bleeding⁴. Therefore, this choice is not correct based on the platelet count provided.

Choice A reason:

While pulmonary function studies are an important part of the preoperative assessment and postoperative follow-up for lung cancer patients, they are not typically something a patient would be immediately prepared for post-lobectomy. These studies are usually scheduled for a later date to assess the impact of the surgery on lung function.

Choice B reason:

A sternal incision is not commonly associated with a lobectomy, which involves an incision in the chest wall, not the sternum. Sternal incisions are more often related to procedures that require access to the heart or the central chest area, such as open-heart surgery.

Choice C reason:

Moderate pain is expected after any major surgical procedure, including a lobectomy. However, pain management is a standard part of postoperative care, and patients are typically informed about pain control measures rather than being prepared to expect pain as a postoperative event.

Choice D reason:

The placement of a chest tube is a standard part of care following a lobectomy. The chest tube allows for drainage of fluid and air from the pleural space, ensuring proper lung expansion and preventing complications such as pneumothorax. Patients should be educated about the chest tube's purpose, care, and the sensations they may experience while the tube is in place.